ADEA-ADEE Shaping the Future of Dental Education III: The impact of scientific technologies and discoveries on oral health globally.

The central purpose of scientific research and emerging dental health technologies is to improve care for patients and achieve health equity. The Impact of Scientific Technologies and Discoveries on Oral Health Globally workshop conducted joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, highlighted innovative technologies and scientific discoveries to support personalized dental care in an academic and clinical setting. The 2019 workshop built upon the new ideas and way forward identified in the 2017 ADEE-ADEA joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education II held in London. During the most recent workshop the approach was to explore the "Teaching Clinic of the Future". Participants applied ideas proposed by keynote speakers, Dr. Walji and Dr. Vervoorn to educational models (Logic Model) in an ideal dental education setting. It is only through this continuous improvement of our use of scientific and technological advances that dental education will be able to convey to students the cognitive skills required to continually adapt to the changes that will affect them and consequently their patients throughout their career. This workshop was a valuable experience for highlighting opportunities and challenges for all stakeholders when aiming to incorporate new technologies to facilitate patient care and students' education.

Cooperative financial institutions: A review of the literature.

Financial cooperatives play an important role in the financial systems of many countries. They act as a safe haven for deposits and are major sources of credit for households and small- and medium-sized firms. A not-for-profit orientation (in many cases) and a focus on maximising benefits to members have ensured the enduring popularity and sustainability of financial cooperatives. This is particularly evident since the global financial crisis when financial cooperatives continued to extend credit to members as many profit-orientated commercial banks restricted credit to households and firms. The overarching theme of the first part of this review is the structural and behavioural characteristics of financial cooperatives. In this part we consider, the origin and diffusion of financial cooperatives, network arrangements, the business model, relationship banking, balancing the interest of members, tax treatment and regulatory framework. The second part has performance and contribution to the real economy as the overarching theme. In this part we consider, efficiency and sustainability, mergers, acquisitions and failures, the benefits (and challenges) of FinTech and the contribution of financial cooperatives to the real economy including during times of crisis. The paper concludes with a summary of what we now know (and do not know) about financial cooperatives and provides suggestions as to where future research may usefully concentrate.

Comparison of frequency-based techniques for assessment of baroreceptor sensitivity and heart rate variability.

Heart rate variability (HRV) and baroreceptor sensitivity (BRS) quantify autonomic variability in heart pacing and the autonomic response to blood pressure changes respectively. By necessity, the signals used to calculate HRV and BRS (systolic blood pressure (SBP) and RR interval) have one data point every cardiac cycle. Due to inherent variability in heart rate, these are non-uniformly sampled data. A number of calculation methods exist that adjust for non-uniform sampled signals. This study compared frequency domain methods of HRV and BRS calculation to ascertain whether more complex methods resulted in different results to simpler methods. Wistar rats (n=10), and rats with induced diabetes (n=8) were anesthetized and SBP and RR interval measured for a period of approximately 5 minutes. This data were analyzed using the sequence technique (for BRS), fast Fourier transform (FFT), non-uniform discrete Fourier transform (NDFT) and an extended Lomb-Scargle Periodogram (LSP). There were small but significant differences in NDFT from LSP technique for both BRS in the low frequency range (p=0.005) and HRV in the high frequency range (p=0.001). The NDFT technique was also significantly different to FFT technique for BRS in the low frequency range (p=0.023). All other methods were not statistically different. However, all techniques showed the same results comparing diabetic to control rats. This study shows more complex methods that correct for the non-uniformity of the sampling have significant differences but those differences are small to the point of not altering findings associated with HRV or BRS.

Guidelines for the assessment of oral mucositis in adult chemotherapy, radiotherapy and haematopoietic stem cell transplant patients.

Oral mucositis (OM) is a serious consequence of some chemotherapy and radiotherapy regimens. A number of reliable instruments are available to assess OM, but none are universally accepted. A unique collaboration of multi-disciplinary experts from Europe was formed to make recommendations on OM assessment, based on a systematic literature review and the experts' experience. The main recommendations are listed. There should be a comprehensive baseline assessment. OM should be frequently assessed using a standardised instrument, or a combination of instruments. Physical, functional and subjective changes should be measured. Subjective measures should be assessed prior to any physical examination. The use of pain scoring, in particular patient self-reporting, should form part of any OM assessment. Any assessment instrument should be validated, easy to use and comfortable for the patient. Training of, and monitoring in, the use of the instrument is vital to successful monitoring of OM.

Ensuring accurate oral mucositis assessment in the European Group for Blood and Marrow Transplantation Prospective Oral Mucositis Audit.

Oral mucositis (OM) has substantial negative clinical, quality-of-life, and economic consequences for patients with haematologic malignancies who require myeloablative chemotherapy or radiotherapy. Uniform training in OM assessment is infrequent in clinical practice, so the true incidence and duration of OM are unknown. Nurses and physicians from the European Group for Blood and Marrow Transplantation recently undertook an audit of 214 patients (197 evaluable patients) treated at 25 centres, the Prospective Oral Mucositis Audit (POMA), to determine the incidence, severity, and duration of OM. To standardise the assessment of OM severity, the World Health Organization (WHO) Oral Toxicity Scale was used across centres. This article focuses on the quality control analyses that were conducted to ensure that OM was accurately assessed across all 25 centres. Twenty-two trainers, who received comprehensive training about POMA study design, pathobiology of OM, and endpoint assessment, educated staff at the 25 transplantation centres about OM assessment. The trained staff collected data by completing daily worksheets for each patient. Three quality control analyses, of 82, 1949, and 4111 worksheets respectively, showed a nurse assessment accuracy rate of 74%, 90%, and 90%. The most common errors were in assigning WHO grade 0 or 1. This analysis shows that training of nursing staff had a positive effect on assessment of OM severity, which should ultimately lead to improvement in the quality of supportive care.